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Mortality from coronary heart disease is greater in young black men than in their white counterparts. On the other hand, the morphologic correlates of coronary heart disease, namely, coronary artery stenosis and occlusion, thrombus, and myocardial lesions are strikingly similar in coronary heart disease deaths regardless of race. Diseases related to atherosclerosis and coronary heart disease such as cerebrovascular disease, hypertension, diabetes, and chronic renal disease are also more frequent in young black men than in young white men, but the excess of coronary heart disease in blacks is evident irrespective of these diseases. Our findings are based on a community-wide survey of black and white men, 25 to 44 years of age, who lived, died, and were autopsied in Orleans Parish (county) Louisiana. Since the morphologic features of the disease are similar in the two races, investigation of risk factors is needed to further explain mechanisms associated with the relatively high coronary heart disease death rate in young blacks.
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